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Abstract: TH-PO949

ESKD and Incidence and Outcomes With COVID-19: A 2-Year Review in US Veterans

Session Information

Category: Coronavirus (COVID-19)

  • 000 Coronavirus (COVID-19)

Authors

  • Garcia-Touza, Mariana, VAMC, Kansas City, Missouri, United States
  • Singh, Vikas, VAMC, Kansas City, Missouri, United States
  • Gupta, Aditi, KUMC, Kansas City, Kansas, United States
  • Boinpelly, Varun Chandra, VAMC, Kansas City, Missouri, United States
  • Sharma, Ram, VAMC, Kansas City, Missouri, United States
  • Sharma, Rishi, UMKC, Kansas City, Missouri, United States
  • Hawkinson, Dana, KUMC, Kansas City, Kansas, United States
  • Savin, Virginia J., VAMC, Kansas City, Missouri, United States
  • Sharma, Mukut, VAMC, Kansas City, Missouri, United States
  • Wiegmann, Thomas, VAMC, Kansas City, Missouri, United States

Group or Team Name

  • VAMC
Background

The COVID-19 pandemic has greatly impacted the global community. About 800,000 patients in the United States have ESKD, hence it is important to understand its interaction [WT(1] with COVID-19 .

Methods

We used the Veterans Affairs (VA) COVID-19 resource data base to examine the incidence and outcomes of ESKD (CKF2yrs) with COVID-19 in US Veterans. The database included standard hospital data, administrative and clinical records from VA and non-VA sources from March 2020 to April 2022. We examined the effect of basic demographic and common risk factors on all-cause mortality, and other outcomes (Table). Statistical analysis, frequency distributions, ODDs Ratios (OR) used SAS (Enterprise guide 7.1).

Results

The total study population consisted of 1,994 533 Veterans, and 27.9% of them (n=557,208) tested positive for COVID-19 (40% Alpha, 20.4 % Delta, 39.6% Omicron). Age, hypertension, diabetes mellitus type 2, Smoking status, Gender or Race had little effect (OR 0.86 – 1.01) while body mass index had moderate effect (OR 1.27) on incidence. ESKD was also increased significantly (OR 1.2).
There were 7942 ESKD patients with 7452 on dialysis tested positive for COVID-19. Common risk factors were more prevalent in the ESKD cohort (OR age 5.5, male sex 4.6, hypertension 4.9, and diabetes 7.9) while the effect of BMI was lost (OR 0.63). Propensity matching was used for these conditions to isolate the effect of ESKD on outcomes. ESKD was associated with increased mortality and morbidity (Table). Mortality was reduced by 30% with Omicron.

Conclusion

ESKD in Veterans is associated significantly with increased of COVID-19 and its variants, higher rates of ICU admission, ventilator use, oxygen need, ER visits, readmission and all-cause mortality.

Funding

  • Veterans Affairs Support